Medication Questions

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CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 8/25/2008 5:36 PM (GMT -7)   
Hello everyone,

First post here on the forums. I have been reading posts on the site for a few weeks now and now I have a question.

First off some background. I have been diagnosed with Chrons for about two years now and was prescribed Pentasa. At first the Pentasa seemed to knock out the pain, but the symptoms eventually started to come back. My doctor took me up to 2-500mg of Pentasa x4 day. This helped for a while and the pain came back so he put me on 3-3mg of Entorcot each day, which appeared to help for a few months.

Now, for the past two weeks I have got progressively worse in symptoms so I called my doctor today. The nurse practitioner prescribed me Prednisone (5 week taper) and Imuran. She said to stop taking the entocort tomorrow and startup with the Prednisone and Imuran while taking the Pentasa.

Has anyone here taken a combination of these medications? The side effects of Imuran seem a little nerve racking. For example, the increased risk of tumors and lowered white blood cell count.

Any thoughts for a person with new meds?

LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 8/25/2008 5:55 PM (GMT -7)   
You will find side effects like that often on immunosuppressant medicine like Imuran, but try not to worry too much and gauge the situation based on how it effects you personally. My doctor is trying to get me on the one called Humira, and I was terrified after reading its potential(and similar to Imuran's) side effects. I later spoke to quite a few people who were on it who said that it completely turned their lives around. It's really 50/50 in my opinion. TNF blockers are scary to read about, but you won't know until you try them and if you really are not comfortable on it you can still make the decision not to take it.

Out of the medications you listed I am taking Pentasa and Prednisone(tapered down to 30 mg a day up to this point, started on 40 mg and stayed for several months). The pentasa actually made me feel worse initially, but I was told it wouldn't kick in very quickly so I stayed with it and I do feel much better. The prednisone worked immediately when I first started taking it, but stopped working after a while. I had to have a jumpstart with steroids by IV and then I started back on the tablet form which is working for me now though I do not enjoy the moonface and weight gain(or the distribution of the weight gain rather).

My doctor is actually trying to start me on Imuran this September. I'm really anemic though so he put me on tandem plus iron supplements and will have to take some blood tests to make sure it is safe first.

Good luck with your medication by the way!
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.


CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 8/25/2008 7:32 PM (GMT -7)   
Thanks for replying!

I am starting out on 40 mg of Prednisone as well. Did you take it all at once or spread it out throughout the day? I wake up a lot during the night as it is and hope it doesn't make it worse.

I had to have a blood test prior to taking the Imuran to see how well I would metabolize it. She said I was an intermediate metabolizer so we would have to work into it. The doctor wants me to have regular blood tests to monitor my blood levels while taking the Imuran. She didn't specify how long I will be on it, but a positive change in my symptoms is definitely welcomed.

Good luck with your meds and hope all goes well if you are able to take Imuran.

LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 8/25/2008 7:47 PM (GMT -7)   
I take it all at once, but I took 20mg in the morning and then 20 mg in the evening at on point during my last bad flare just to get through the day and night without doubling over in pain hah. I did notice an initial inability to sleep while on it though..and something similar to restless leg syndrome in my arms. I swear it's impossible to sleep when you want to pop your arm out of the shoulder every 5 seconds..
Good luck with the sleep stuff. I heard you can take some sort of tylenol that induces sleep if you have problems. Don't take my word for it because my head was a little bit fuzzy when my doctor was giving me permission to do so, but maybe there is something you can take to help you sleep better if the prednisone exacerbates that problem. Here is to it not though! Good luck with it. Let me know how the Imuran goes too by the way. I really hope it works :)
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.


CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 9/1/2008 8:14 AM (GMT -7)   
Things don't seem to be going to well right now.

Tomorrow will be a week since I started taking the Prednisone, Imuran & Pentasa vs what I was taking (Entocort & Pentasa). So last Monday I took my last 9mg dose of Entocort and Tuesday started the Prednisone instead. Ever since then, my stomach pain has gotten worse, diarrhea and bleeding increased.

I am confused... Isn't the Prednisone supposed to do the opposite? I called the doctors office and they said the I shouldn't be having these symptoms with the Prednisone. They had me get a blood test which will come back tomorrow and a CAT Scan schedule this Friday to see if I am flaring, etc.

Any help? Suggestions? Please?

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10392
   Posted 9/1/2008 8:19 AM (GMT -7)   
As far as the stomach pain, are you taking the Pred with food? Taken on an empty stomach, it can cause stomach ulcers and bleeding.
Judy - Southern US 
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 9/1/2008 8:32 AM (GMT -7)   
Yea, I usually take it with lunch or a snack. The stomach pain usually tends to be in the evening.

CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 9/1/2008 8:38 AM (GMT -7)   
Another thing, I may have some minor pain throughout the day. But when I have real bad pain (right where the rib cage starts to separate) within about 20 minutes I am usually on the toilette with diarrhea.

I also have a fissure which does not help with the frequent BM. I try to soak in the shower once or twice a day. Can I use a sitz bath with Epsom salt with a fissure?

gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 9/1/2008 8:58 AM (GMT -7)   
Hi I had bad heartburn while on pred. I had to get a perscription for that .lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,and still alive.lol gail


CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 9/1/2008 9:02 AM (GMT -7)   
Right now I would rather have heartburn instead of the horrible pain.... I just feel like that part of me is about to explode.... But my rectum does instead...

Sorry for the grossness.

potatoqwn
Regular Member


Date Joined Jan 2006
Total Posts : 355
   Posted 9/1/2008 10:04 AM (GMT -7)   
Call your doctor and get some meds for your fissure. There are plenty to use including Cortafoam and Cort Enema. I have also heard that putting olive oil on it will help. You can try baby rash ointment too. Fissures are just awful. So sorry.
I hope you get your medications worked out to help with all your pain.

belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 9/1/2008 10:50 AM (GMT -7)   
Hi Crohnnieman:

There is some evidence to suggest that for some people it may not be advisable to take pentasa at the same time with imuran. there is some suggestion that for some people pentasa actually lessens the effectiveness of imuran. I have been on and off again with pentasa for years. At one time, I was convinced that the pentasa was actually exacerbating my symptoms of pain and urgency, especially around the anus. Within the last five years I have gone back on pentasa and then found I needed to begin imuran. After two years on imuran I began developing liver toxicity this spring. Instead of reducing the imuran dose, my doc and I decided to wean off pentasa and reduce some of my other medications. I'm now off pentasa and my liver enzyme levels are back to normal. I actually think my symptoms are better controlled now than when I was on both medications.

Maybe you could do a little research and talk to your physician. You will have to stay on your present medications for at least 3-6 months because it takes that long for the imuran to take full effect, but at some point you might want to consider eliminating some of your meds.

Hope the imuran helps you achieve a reduction in your nasty symptoms.
Belleenstein:

30+ years living with Crohn's.


CrohnnieMan
Regular Member


Date Joined Aug 2008
Total Posts : 190
   Posted 9/1/2008 11:45 AM (GMT -7)   
Thank you all for your help. Very appreciated :)

Potaoqwn: I have used a couple of things to help the fissure previously. Cort enema and something called proctofoam (burned!). It will go away for a while or get better, but eventually comes back. A couple of weeks ago I was prescribed this Nifedipine that you have to get at a pharmacy that can mix it there. I tried using the applicator, but darn if it doesn't hurt sticking something hard into something so swollen. So I applied it outside with my finger and has helped some, just wish there was a easier way to get it where it needs to go...

Belleenstein: Something in my head has always made me think that Pentasa created more urgency around the anus as well. My doctor said it will take at least 5 weeks before I notice anything from the Imuran. I really hope it will help because my rectum needs a break so my fissure can heal!
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